Why Did You Draw My Blood?: A Model for Lab Follow-Up Allowing Dynamic Treatment Plans at a Student-Run Free Clinic

Abstract

Introduction/Problem: Prompt review and communication of lab results to patients is critical for forming appropriate treatment plans, but it can be a difficult task for student-run free clinics (SRFCs) due to a number of limiting factors, including week-to-week turnover of clinic volunteers and staff. The previous model employed by our SRFC placed the responsibility on one clinic manager the morning of the following clinic day, one week later. This placed a necessary but disproportionate stress on this clinic manager who was less familiar with the previous week’s patient encounters and could not make dynamic changes in patients’ treatment plans due to time constraints. We will present the details of a new model employed by our SRFC for lab follow-up. Methods/Interventions: The responsibilities of entering lab results into the electronic medical record (EMR) and calling patients with their results is divided among five clinic managers to be completed each week following Saturday clinic. Completion of lab follow-up is documented in a shared HIPAA-secure Google Sheet. This hand-off sheet was reviewed with cross-reference to the EMR to evaluate the new model. Results: From March to November 2021, a total of 324 phone conversations and an additional 170 attempts to communicate lab results with patients were documented. Twenty-four of those conversations resulted in a follow-up appointment being made sooner than planned during the previous encounter; 41 conversations included counseling on lifestyle modifications; and 53 conversations included additional counseling on the results, return/emergency department precautions, or connection to a higher level of care. Seventy-three percent of the conversations communicating abnormal results had actions like these beyond communication of the results documented. Conclusion: Dividing lab follow-up responsibilities among clinic leadership following each clinic day allows patients to be more in control of their health and avoids delays in care. This model also relieves pressure and saves time for volunteers the next clinic day by allowing them to focus on the encounters occurring that day. Developing a systematic approach for communication of lab results was an advancement for our SRFC, and this model can be applied at SRFCs across the nation.